TY - JOUR
AU - Motta, Melissa
AU - Ramadan, Amanda
AU - Hillis, Argye E.
AU - Gottesman, Rebecca F.
AU - Leigh, Richard
PY - 2015
M3 - 10.3389/fneur.2014.00280
SP - 280
TI - Diffusion–Perfusion Mismatch: An Opportunity for Improvement in Cortical Function
JO - Frontiers in Neurology
UR - https://www.frontiersin.org/article/10.3389/fneur.2014.00280
VL - 5
SN - 1664-2295
N2 - Objective: There has been controversy over whether diffusion–perfusion mismatch provides a biomarker for the ischemic penumbra. In the context of clinical stroke trials, regions of the diffusion–perfusion mismatch that do not progress to infarct in the absence of reperfusion are considered to represent “benign oligemia.” However, at least in some cases (particularly large vessel stenosis), some of this hypoperfused tissue may remain dysfunctional for a prolonged period without progressing to infarct and may recover function if eventually reperfused. We hypothesized that patients with persistent diffusion–perfusion mismatch using a hypoperfusion threshold of 4–5.9 s delay on time-to-peak (TTP) maps at least sometimes have persistent cognitive deficits relative to those who show some reperfusion of this hypoperfused tissue.Methods: We tested this hypothesis in 38 patients with acute ischemic stroke who had simple cognitive tests (naming or line cancelation) and MRI with diffusion and perfusion imaging within 24 h of onset and again within 10 days, most of whom had large vessel stenosis or occlusion.Results: A persistent perfusion deficit of 4–5.9 s delay in TTP on follow up MRI was associated with a persistent cognitive deficit at that time point (p